Colorado Political Giving

The Colorado Dental Political Action Committee (CODPAC) raises money to support state legislators who understand the importance of dentistry and are committed to the oral health of Coloradans. CODPAC dollars are the general fund used to educate legislators on dental issues and support legislators who back dentistry’s key issues.

The Colorado Dental Small Donor Committee (CDSDC), as a small donor committee, limits individual contributions to $50 per year, per person. But a small donor committee may give a candidate more than 10 times more than a regular political action committee, like CODPAC. CDSDC dollars are used to support legislators who have gone above and beyond their peers to support dentistry – dentistry’s best legislative champions. CDSDC has grown to be a notable player in Colorado’s healthcare political giving landscape.

Both CODPAC and CDSDC play a critical role in increasing dentistry’s prominence at the state Capitol. Partnering a small donor committee together with CODPAC positions dentistry among a handful of elite political influencers in Colorado healthcare.

To maximize political influence, Colorado Political Giving contributions are split between CODPAC and CDSDC, with the first $50 given in a calendar year going to CDSDC and any remaining state political contributions (up to $575 per two-year election cycle) going to CODPAC. If you would prefer a different allocation for your political contribution, simply contact the CDA at 303-740-6900.

CODPAC and the American Dental Political Action Committee (ADPAC) raise money to support state and federal legislators who understand the importance of dentistry and are committed to the enhancement of oral health. CODPAC and ADPAC are designed for CDA members only. Prohibited contributions will be returned. All donations to ADPAC must be made from personal accounts. Contributions from corporate or business accounts cannot be accepted. Contributions to CODPAC and ADPAC are not tax-deductible. Contributions are strictly voluntary and members can choose not to give without threat of reprisal or retaliation. The FEC and secretary of state require that certain information on each donor (name, address, occupation, name of employer) be collected and reported to the agency.

Colorado Political Giving

Contributing helps the CDA and its members secure a successful future for the dental profession.

ELECTION SUPPORT

Each election year, following the state legislative session, the CDA conducts a screening process to evaluate all candidates running for state legislative office. During this process, the candidates complete a questionnaire on key dental issues and participate in interviews with CODPAC leadership. This process helps determine what level of support the candidate will receive. If a candidate chooses not to participate in the interview/questionnaire process, he/she is not considered for an endorsement or contribution.

After completing the candidate evaluation process for 2016, CODPAC contributed $17,500 to support friends of dentistry who are seeking seats in the state legislature. The small donor committee contributed an additional $20,500.

To access your legislator’s voting record, use Lookup Your Legislator link and enter your home ZIP code or address. Then click on the name of your state representative or state senator. Click on the “Votes” tab of your legislator’s record to view his/her voting record on key dental issues.

2018 LEGISLATIVE AGENDA

The 2018 state legislative session brought critical issues for dentistry. This year saw continued discussions about dental access and workforce, including a bill regarding increasing dental hygienists’ scope of practice by allowing them to treat patients with silver diamine fluoirde, and several opioid bills that put restriction on prescribing limitations for all prescribers, including dentists.

LEGISLATIVE SUCCESS

Over the past several years, the CDA and its membership have had a strong voice at the state Capitol. It’s because of this joint effort that the CDA can count the following as important legislative achievements.

Health insurance reform was a top topic of conversation this year at the state Capitol. In addition to conversations at the federal level about the future of the Affordable Care Act, state-level bills addressed coverage mandates, carrier-provider relations and even a sunset review of the state office that regulates insurance. Some of the key bills pertinent to dentists included:

Senate Bill 190, which PASSED, will stop carriers from dictating fees for services they do not cover in dental plans. The practice of dental plans dictating fees for noncovered services has been an ongoing concern for many dental offices, as it can disrupt patient choice of dental services and the patient-provider relationship. It can also interfere in fair delivery of dental services for patients across the state, creating cost shifting and barriers to care. The bill passed the Colorado legislature, has been signed by the governor and takes effect on Aug. 9, 2017.

Senate Bill 88, which PASSED, addresses the growing trend of narrow networks with restricted provider panels. This bill requires carriers and any intermediaries used to manage or administer health benefits to disclose the standards used to select network providers and tier providers in tiered plans. The bill passed the Colorado legislature, has been signed by the governor and takes effect on Jan. 1, 2018.

House Bill 1173, which PASSED, will help address situations where a carrier retaliates against a provider who disagrees with a medical policy or patient policy determination. The bill would prohibit an adverse action (such as termination of a provider’s contract) if a provider testifies, files a complaint, participates in an investigation or communicates with a public official or law enforcement about the carrier’s policy. There have been reports about dental carriers retaliating against dentists for such activities in the past. The bill passed the Colorado legislature, has been signed by the governor and takes effect on July 1, 2017.

A number of other network and insurance reform efforts were pursued in 2017, including HB 249, a sunset review of the Division of Insurance that regulates carriers.

Additional insurance reform bills were pursued but did not pass. Senate Bill 133 would have required the state Division of Insurance to investigate provider complaints against insurers, especially when there are patterns of complaints, and would have required notification to the complaining provider about the outcome or resolution of the complaint. House Bill 1247 would have addressed patient choice of provider and allow any willing provider to adhere to the terms of a carrier’s contract to participate in the carrier’s network. Senate Bill 206 would have addressed charges and patient notice for services delivered by an out-of-network provider at an in-network facility, a situation sometimes encountered by oral surgeons and other dentists who provide hospital or facility-based care. The bill would have required that health insurance plans pay either the billed charges or 80% of regional usual and customary fees to out-of-network providers that render services at in-network facilities, and created a dispute resolution process for cases where the provider feels these payment criteria were not met.

House Bill 1010, which PASSED, made a few technical changes to the Dental Practice Act, based on recommendations of a joint task force between the CDA and Colorado Dental Hygienists Association (CDHA). The bill addressed some clean-up items on lasers, dental hygiene prescribing and liability coverage requirements in follow-up to changes made during the 2014 Sunset Review. This bill passed, was signed by the governor, and takes effect Aug. 9, 2017. Under the signed bill, the Colorado Dental Board will have a bit more flexibility to write rules on laser usage by dental hygienists, though any changes must comply with existing scope of practice. The bill clarified that dental hygienists may maintain emergency drugs relevant to their scope of practice when acting in collaboration with a licensed dentist. The Colorado Dental Board will be conducting rulemaking related to this bill in coming months, starting at its July 12 meeting.

House Bill 1165, which PASSED, better outlines timelines and notification processes related to disciplinary actions handled by the state Department of Regulatory Agencies (DORA), the state agency that includes the Colorado Dental Board. The bill could help ensure a bit more consistency and efficiency in DORA processes for both dentists responding to a complaint and any patients involved. The bill passed the Colorado legislature, has been signed by the governor and is currently in effect.

House Bill 1254, which DID NOT PASS, was a bill that sought to remove current limits to non-economic damages in cases of wrongful death of a child under the age of 21. This bill could have affected liability coverage premiums for healthcare providers, as the bill did not initially exempt healthcare cases (which fall under different and much tighter limits in current law). The healthcare community worked jointly to amend the bill to exempt healthcare providers in the House, and to ultimately kill the bill in the Senate.

House Bill 1121, which DID NOT PASS, would have required all healthcare providers with prescribing authority, including dentists and dental hygienists, to undergo a background check at the time of initial licensure or during the provider’s next license renewal. Background checks are a requirement for licensure of healthcare providers in nearly all U.S. states. The CDA worked hard to streamline this bill and associated processes for dental providers in case it passed. The CDA successfully amended the bill to ensure the background check would be a one-time (as opposed to ongoing) requirement, to give more convenient options for where the check could be done and to ensure that the requirements would not apply to retired licensees. The bill had a lot of consumer and legislator support (though also some opposition in the provider community), but faced a tough road due to a large cost to the state to implement. This bill is expected to be pursued again in future legislative sessions.

HB 1350, which DID NOT PASS, sought to address opioid prescribing in light of growing attention to the opioid abuse and addiction epidemic. The bill proposed to allow pharmacists to fill a prescription in increments (partial fill) as opposed to in full in order to reduce leftover prescription drugs in medicine cabinets. The bill faced a late introduction and rocky political road, and ultimately failed to address many of the broader topics needed to meaningfully address the opioid epidemic. An interim legislative task force was appointed to invest additional attention into this topic over summer months. The CDA will be participating in these interim task force meetings in hope that productive conversations about improvements to the state’s Prescription Drug Monitoring Program (PDMP), treatment options, and cost sharing parameters for partial fill allowances will be addressed in addition to any prescribing changes or limitations.

HB 1139, which PASSED, sought to enhance the section of state law that prevents a healthcare provider, including a dentist, from collecting any fee from a Medicaid patient for a covered service, regardless of whether the provider participates with Medicaid or not. Current state law imposes a penalty on providers who engage in this type of activity, and penalties have historically been applied even when providers mistakenly bill a patient (or were unaware of the patient’s Medicaid coverage status). HB 1139 improved current processes by explicitly allowing the provider a chance to correct mistaken billing before penalties are applied. It also converted the penalty from a percentage of the total fee collected from the patient to a flat $100 fee, making the penalty more predictable for providers when applied (and likely reducing the dollar value of the penalty for dentists in many cases). Also, as a result of negotiations on SB 4, which DID NOT PASS, the CDA was successful in having Medicaid commit to issuing a bulletin clarifying that a non-Medicaid provider may collect a private plan co-pay from a patient who is also covered by Medicaid (so long as the patient has signed an appropriate waiver form) without violating this section of law, an issue that has been a challenge for dentists who treat patients with dual dental coverage in the past. The CDA worked with partners to also amend this bill to specify that this section of law would not apply if a patient misrepresents their Medicaid coverage status and the provider can provide documentation of the misrepresentation. The bill passed the Colorado legislature, has been signed by the governor and is currently in effect.

In 2017, the legislature revisited past efforts to require healthcare providers and facilities to publish a list of cash pay prices for services that a third party carrier (insurer or benefit plan) does not pay for. Under SB 65, which PASSED, a list of the 15 most common healthcare fees provided by the office is required to be made available electronically or on the provider’s website, and would need to be updated annually. Dentists are specifically included in the scope of the bill, though practices with 6 or fewer providers may opt to provide the information by posting in the office, as opposed to providing it electronically or on a website. Disclosure language is required indicating that the fee published is not a guarantee of cost to an individual. Insurers are also prohibited from using the information required in SB 65 to their financial advantage in contract negotiations. There are a number of implementation hurdles that will need to be ironed out in coming months, including the variability in reporting fees for codes versus procedures (which can be comprised of a number of codes that may differ from patient to patient) and managing corresponding patient expectations.

In 2015, your political contributions worked to influence state legislators to:

Protect dentists from insurer rating systems that calculate ratings solely based on treatment fees. The bill, HB 1191, takes effect in August 2015. All insurer rating systems for dentists will be required to comply with protections and fairness standards outlined in the bill at this time.

Authorize dental hygienists to perform interim therapeutic restorations (ITR) subject to appropriate training, experience and supervision requirements. The bill, HB 1309, takes effect in August 2015. The ITR program for dental hygienists is a five-year pilot program that will be evaluated by the state legislature in 2021 for efficacy and any needed adjustments.